BACKGROUND: Tuberculosis itself causes not only lung parenchymal destruction but also pulmonary vascular damage. Secondary emphysema also causes pulmonary vascular damage, which can develop as a late sequela of pulmonary tuberculosis. Therefore, pulmonary circulatory impairment tends to be more severe in post-tuberculosis emphysema than in primary emphysema. In post-tuberculosis emphysema, the right ventricular function may play an important role. However, little information regarding the right ventricular function is available. The purpose of this study was to evaluate and compare the right ventricular function between post-tuberculosis emphysema and primary emphysema. METHOD: Post-tuberculosis emphysema(PTE) or primary emphysema(PE) was diagnosed by history, HRCT finding and pulmonary function. Twenty patients with post-tuberculosis emphysema were matched with 20 patients with primary emphysema according to both FEV1 and FVC. Arterial blood gas analysis and echocardiography were done at rest and immediately after symptom-limited exercise. The right ventricular function was evaluated with the right ventricular ejection fraction using a modification of Simpson's method. RESULTS: There was no significant difference inthe demographics and pulmonary function between the two groups. In post-tuberculosis emphysema, the PaCO2 was higher (42.9±4.7 vs 38.8±3.1 mmHg at rest ; 47.9±7.0 vs 41.1±5.9 mmHg after exercise ; p<0.01) and the right ventricular ejection fraction was lower (57.6±6.5 vs 61.4±4.7 % at rest ; 51.1±10.8 vs 59.8±6.6 % after exercise ; p<0.01) both at rest and after exercise. The PaO2 after exercise was also lower (65.7±12.6 vs 80.2%±14.4 mmHg, p<0.01), while the PaO2 at rest tended to be lower(82.9±12.0 vs 87.8±7.5, p>0.05). In both groups, right ventricular ejection fraction correlated with the PaO2 after exercise(PTE r=0.536, PE r=0.557), and the PaCO2 at rest(PTE r=-0.576, PE r=-0.588) and after exercise(PTE r=-0.764, PE r=-0.619). CONCLUSION: Impairment of the right heart function and gas exchange were more serious in post-tuberculosis emphysema than in primary emphysema, and gas exchange may be influenced by the right ventricular function in post-tuberculosis emphysema.
Blood Gas Analysis ; Demography ; Echocardiography ; Emphysema* ; Heart ; Humans ; Lung ; Stroke Volume ; Tuberculosis ; Tuberculosis, Pulmonary ; Ventricular Function, Right*

Left ventficular ejection times were measured by four different methods in 200 healthy males and females from the polygraphic tracings including an apexcardiogram, a phonocardiogram and a carotid pulse tracing. The results obtained by each method were compared and the adequacy of each method was critically reviewed. It was felt that the method measuring the left ventricular ejection time from the carotid pulse tracing was the most reasonable. However, there was a significant correlation between the carotid-derived values and those obtained by other methods, thus, regression equations for the relationship of the latter values to the fromer were obtainable.
Female ; Humans ; Male

No abstract available.
DNA* ; Laryngeal Neoplasms*

Pure red cell aplasia in uncommon disorder characterized by finding of anemia, absence of nucleated red blood cell in the marrow, absence of reticulocytes in the peripheral blood and normal peripheral platelet and leukocytes counts. We experienced one case of pure red cell aplasia associated with hemolytic anemia characterized by hemoglobinuria, reticulocytopenia, and erythroid hypoplasia of the bone marrow. The cause of the illness was not definitely identified, but we concluded that this patient had simultaneous occurrence of PRCA and hemolytic anemia following administration of diphenylhydantoin after craniotomy rather than virus or bacteria induced. The simultaneous occurrence of PRCA and hemolytic anemia in uncommon and the mechanism for diphenylhydantoin induced PRCA and hemolytic anemia is unclear.
Anemia ; Anemia, Hemolytic ; Bacteria ; Blood Platelets ; Bone Marrow ; Craniotomy ; Erythrocytes ; Hemoglobinuria ; Humans ; Leukocytes ; Phenytoin ; Red-Cell Aplasia, Pure* ; Reticulocytes

It is difficult to know whether the presence of infection in the plantar ulcer in patients with leprosy or not. Because routine bacteriology is often unhelpful, we need to investigate diagnostic method in this situation. C-reactive protein(CRF) levels have been known to be useful in detecting infection in some diseases. In this study, CRP levels were measured in 20 leprosy patients with plantar ulceration and 14 patients with leprosy alone. The results were as follows : 1. There was no elevation of CRP levels in patients with leprosy alone, and in the majority of patients with ulcers. 2. Of 20 patients with plantar ulcers, four had raised CRP levels one had clinically obvious infection, and three had erythematous skin of uncertain cause surrounding their ulcers. 3. Treatment with an appropriate antibiotics reduced CRP levels to normal, which was associated with clinical improvement. Therefore, it is suggested that increased CRP levels can be a useful probe for detecting significant bacterial infection in plantar ulcers of leprosy patients.
Anti-Bacterial Agents ; Bacterial Infections ; Bacteriology ; Foot Ulcer ; Humans ; Leprosy* ; Skin ; Ulcer*

PURPOSE: The objective of this study was to find the predictors and generate a prediction scoring model of nonresponse to intravenous immunoglobulin in patients with Kawasaki disease. METHODS: We examined 573 children diagnosed with KD at the Severance Children's Hospital between January 2009 and december 2012. We retrospectively reviewed their medical records. These patients were divided into 2 groups; the experimental group (N=433) and the validation group (N=140). Each group were divided into 2 groups the intravenous immunoglobulin nonresponders and the responders. Multivariate logistic regression analysis identified predictive factors of intravenous immunoglobulin nonresponders which make predictive scoring model. We practice internal validation and external validation. RESULTS: Multivariate logistic regression analysis identified male, cervical lymphadenopathy, changes of the extremities, platelet, total bilirubin, alkaline phophatase, lactate dehydrogenase, C-reactive protein as significant predictors for nonresponse to intravenous immunoglobulin. We generated prediction score assigning 1 point for (1) male, (2) cervical lymphadenopathy, (3) changes of the extremities, (4) platelet (< or =368,000/mm3), (5) total bilirubin (> or =0.4 mg/dL), (6) alkaline phophatase (> or =227 IU/L), (7) lactate dehydrogenase (> or =268 IU/L), (8) C-reactive protein (>77.1 mg/dL). Using a cut-off point of 4 and more with this prediction score, we could identify the intravenous immunoglobulin nonresponder group. Sensitivity and specificity were 52.5% and 82.4% in experimental group and 37.8% and 81.8% in validation group, respectively. CONCLUSION: Our predictive scoring models had high specificity and low sensitivity in Korean patients. Therefore it is useful in predicting nonresponse to intravenous immunoglobulin with Kawasaki disease.
Bilirubin ; Blood Platelets ; C-Reactive Protein ; Child ; Extremities ; Humans ; Immunoglobulins* ; Korea ; L-Lactate Dehydrogenase ; Logistic Models ; Lymphatic Diseases ; Male ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity

No abstract available.
Humans ; Schools, Medical*

No abstract available.
Animals ; Cricetinae* ; Fertilization in Vitro* ; Humans*

No abstract available.
Holoprosencephaly*

No abstract available.
Centrifugation, Density Gradient* ; Humans* ; Spermatozoa*